2.Cytomegalovirus ventriculoencephalitis in patients without acquired immune deficiency syndrome: a case report
Jiayi LI ; Siyuan FAN ; Hongzhi GUAN
Journal of Apoplexy and Nervous Diseases 2024;41(2):116-118
		                        		
		                        			
		                        			Cytomegalovirus(CMV)ventriculoencephalitis is a type of severe encephalitis caused by CMV infection of the ependyma and brain parenchyma,with the main clinical manifestations of fever,headache,disturbance of consciousness,and convulsions. The opportunistic infection of CMV often occurs in immunocompromised people,mainly in patients with acquired immune deficiency syndrome(AIDS),while nervous system infection is extremely rare in people with competent immune function. This article reports a case of CMV ventriculoencephalitis in a non-AIDS young male patient,with pyrexia and disturbance of consciousness as the initial presentation. Contrast-enhanced magnetic resonance imaging showed a typical enhanced signal shadow of the ventriculomeninges,and a confirmed diagnosis was made based on cerebrospinal fluid CMV examination. We hope that this case of non-AIDS-related CMV ventriculoencephalitis will provide help for clinicians to improve their understanding of the clinical and imaging manifestations of this disease.
		                        		
		                        		
		                        		
		                        			Cytomegalovirus
		                        			
		                        		
		                        	
4.Pathological Types,Expression of Mismatch Repair Protein,Human Epidermal Growth Factor Receptor 2,and Pan-TRK,and Eostein-Barr Virus Infection in Patients With Colorectal Cancer Resected in Tibet.
Han-Huan LUO ; Zhen HUO ; BIANBAZHAXI ; Qian WANG ; DUOBULA ; NIMAZHUOMA ; Zhen DA ; Ping-Ping GUO
Acta Academiae Medicinae Sinicae 2023;45(3):422-428
		                        		
		                        			
		                        			Objective To study the pathological types,expression of mismatch repair protein,human epidermal growth factor receptor 2(HER2),and Pan-TRK,and Epstein-Barr virus(EBV)infection in patients with colorectal cancer resected in Tibet. Methods A total of 79 patients with colorectal cancer resected in Tibet Autonomous Region People's Hospital from December 2013 to July 2021 were enrolled in this study.The clinical and pathological data of the patients were collected.The expression of mismatch repair protein,HER2,and Pan-TRK was detected by immunohistochemical(IHC)staining,and detection of HER2 gene by fluorescence in situ hybridization(FISH)in the patients with HER2 IHC results of 2+ or above.EBV was detected by in situ hybridization with EBV-encoded small RNA. Results A total of 79 colorectal cancer patients were included in this study,with the male-to-female ratio of 1.26:1 and the mean age of(57.06±12.74)years(24-83 years).Among them,4 patients received preoperative neoadjuvant therapy.Colonic cancer and rectal cancer occurred in 57(57/79,72.15%,including 31 and 26 in the right colon and left colon,respectively)and 22(22/79,27.85%)patients,respectively.The maximum diameter of tumor varied within the range of 1-20 cm,with the mean of(6.61±3.33)cm.Among the 79 colorectal cancer patients,75(75/79,94.94%)patients showed adenocarcinoma.Lymph node metastasis occurred in 12(12/21,57.14%)out of the 21 patients with severe tumor budding,13(13/23,56.52%)out of the 23 patients with moderate tumor budding,and 2(2/31,6.45%)out of the 31 patients with mild tumor budding,respectively.The lymph node metastasis rate showed differences between the patients with severe/moderate tumor budding and the patients with mild tumor budding(all P<0.001).The IHC staining showed that mismatch repair protein was negative in 10(10/65,15.38%)patients,including 5 patients with both MSH2 and MSH6 negative,4 patients with both MLH1 and PMS2 negative,and 1 patient with MSH6 negative.Pan-TRK was negative in 65 patients.The IHC results of HER2 showed 0 or 1+ in 60 patients and 2+ in 5 patients.FISH showed no positive signal in the 5 patients with HER2 IHC results of 2+.The detection with EBV-encoded small RNA showed positive result in 1(1/65,1.54%)patient. Conclusions Non-specific adenocarcinoma of the right colon is the most common in the patients with colorectal cancer resected in Tibet,and 15% of the patients showed mismatch repair protein defects.EBV-associated colorectal carcer is rare,Pan-TRK expression and HER2 gene amplification are seldom.The colorectal cancer patients with moderate and severe tumor budding are more likely to have lymph node metastasis.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Adenocarcinoma
		                        			;
		                        		
		                        			Biomarkers, Tumor/genetics*
		                        			;
		                        		
		                        			Colorectal Neoplasms/pathology*
		                        			;
		                        		
		                        			DNA Mismatch Repair
		                        			;
		                        		
		                        			DNA-Binding Proteins/genetics*
		                        			;
		                        		
		                        			Epstein-Barr Virus Infections/diagnosis*
		                        			;
		                        		
		                        			Herpesvirus 4, Human/metabolism*
		                        			;
		                        		
		                        			In Situ Hybridization, Fluorescence
		                        			;
		                        		
		                        			Lymphatic Metastasis
		                        			;
		                        		
		                        			Tibet
		                        			;
		                        		
		                        			Young Adult
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			
		                        		
		                        	
5.Hemophagocytic Syndrome Secondary to Human Parvovirus B19 Infection in an Acquired Immunodeficiency Syndrome Patient:Report of One Case.
Yan ZHANG ; Jun YAN ; Fei WANG ; Jin GAO ; Kai-Long GU ; Ai-Fang XU
Acta Academiae Medicinae Sinicae 2023;45(3):530-532
		                        		
		                        			
		                        			The acquired immunodeficiency syndrome patients with compromised immunity are prone to hemophagocytic syndrome secondary to opportunistic infections.This paper reports a rare case of hemophagocytic syndrome secondary to human parvovirus B19 infection in an acquired immunodeficiency syndrome patient,and analyzes the clinical characteristics,aiming to improve the diagnosis and treatment of the disease and prevent missed diagnosis and misdiagnosis.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lymphohistiocytosis, Hemophagocytic/drug therapy*
		                        			;
		                        		
		                        			Erythema Infectiosum/complications*
		                        			;
		                        		
		                        			Acquired Immunodeficiency Syndrome/complications*
		                        			;
		                        		
		                        			Parvoviridae Infections/diagnosis*
		                        			;
		                        		
		                        			Parvovirus B19, Human
		                        			
		                        		
		                        	
6.Clinical Study of Cytomegalovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.
Yi-Ying XIONG ; Lin LIU ; Jian-Bin CHEN ; Xiao-Qiong TANG ; Qing XIAO ; Hong-Bin ZHANG ; Li WANG
Journal of Experimental Hematology 2023;31(2):513-521
		                        		
		                        			OBJECTIVE:
		                        			To explore the risk factors of cytomegalovirus (CMV) and refractory CMV infection (RCI) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their influences on survival.
		                        		
		                        			METHODS:
		                        			A total of 246 patients who received allo-HSCT from 2015 to 2020 were divided into CMV group (n=67) and non-CMV group (n=179) according to whether they had CMV infection. Patients with CMV infection were further divided into RCI group (n=18) and non-RCI group (n=49) according to whether they had RCI. The risk factors of CMV infection and RCI were analyzed, and the diagnostic significance of Logistics regression model was verified by ROC curve. The differences of overall survival (OS) and progression-free survival (PFS) between groups and the risk factors affecting OS were analyzed.
		                        		
		                        			RESULTS:
		                        			For patients with CMV infection, the median time of the first CMV infection was 48(7-183) days after allo-HSCT, and the median duration was 21 (7-158) days. Older age, EB viremia and gradeⅡ-Ⅳacute graft-versus-host disease (aGVHD) significantly increased the risk of CMV infection (P=0.032, <0.001 and 0.037, respectively). Risk factors for RCI were EB viremia and the peak value of CMV-DNA at diagnosis≥1×104 copies/ml (P=0.039 and 0.006, respectively). White blood cell (WBC)≥4×109/L at 14 days after transplantation was a protective factor for CMV infection and RCI (P=0.013 and 0.014, respectively). The OS rate in CMV group was significantly lower than that in non-CMV group (P=0.033), and also significantly lower in RCI group than that in non-RCI group (P=0.043). Hematopoietic reconstruction was a favorable factor for OS (P<0.001), whereas CMV-DNA≥1.0×104 copies/ml within 60 days after transplantation was a risk factor for OS (P=0.005).
		                        		
		                        			CONCLUSION
		                        			The late recovery of WBC and the combination of EB viremia after transplantation are common risk factors for CMV infection and RCI. CMV-DNA load of 1×104 copies/ml is an important threshold, higher than which is associated with higher RCI and lower OS risk.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Viremia/complications*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Cytomegalovirus Infections/complications*
		                        			;
		                        		
		                        			Hematopoietic Stem Cell Transplantation/adverse effects*
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Cytomegalovirus
		                        			;
		                        		
		                        			Graft vs Host Disease/complications*
		                        			
		                        		
		                        	
7.Comparative Analysis of Primary and Reactivated EB Virus Infection Associated Hemophagocytic Lymphohistiocytosis.
Jiang-Hua LIU ; Wei LIU ; Yan-Ge LI
Journal of Experimental Hematology 2023;31(2):575-580
		                        		
		                        			OBJECTIVE:
		                        			To compare the clinical characteristics of children with hemophagocytic lymphocytosis (HLH) associated with primary Epstein-Barr virus (EBV) infection and EBV reactivation, and explore the effects of different EBV infection status on the clinical indexes and prognosis of HLH.
		                        		
		                        			METHODS:
		                        			The clinical data of 51 children with EBV associated HLH treated in Henan Children's Hospital from June 2016 to June 2021 were collected. According to the detection results of plasma EBV antibody spectrum, they were divided into EBV primary infection-associated HLH group (18 cases) and EBV reactivation-associated HLH group (33 cases). The clinical features, laboratory indexes and prognosis of the two groups were analyzed and compared.
		                        		
		                        			RESULTS:
		                        			There were no significant differences in age, gender, hepatomegaly, splenomegaly, lymphadenopathy, neutrophil count in peripheral blood, hemoglobin content, platelet count, plasma EBV-DNA load, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, albumin, fibrinogen, triglyceride, ferritin, hemophagocytosis in bone marrow, NK cell activity and sCD25 between the two groups(P>0.05). The central nervous system involvement and CD4/CD8 in EBV reactivation-associated HLH group were significantly higher than those in primary infection-associated HLH group, but the total bilirubin was significantly lower than that in primary infection-associated HLH group (P<0.05). After treatment according to HLH-2004 protocol, the remission rate, 5-year OS rate and 5-year EFS rate of patients in EBV reactivation-associated HLH group were significantly lower than those in EBV primary infection-associated HLH group (P<0.05).
		                        		
		                        			CONCLUSION
		                        			EBV reactivation-associated HLH is more likely to cause central nervous system involvement and the prognosis is worser than EBV primary infection-associated HLH, which requires intensive treatment.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Epstein-Barr Virus Infections/complications*
		                        			;
		                        		
		                        			Lymphohistiocytosis, Hemophagocytic/complications*
		                        			;
		                        		
		                        			Herpesvirus 4, Human
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Prognosis
		                        			
		                        		
		                        	
8.Inflammatory granuloma of the trachea: a rare case with Epstin-Barr virus infection.
Zhaodi WANG ; Xuan LU ; Yunmei YANG ; Yuanqiang LU
Journal of Zhejiang University. Science. B 2023;24(6):539-543
		                        		
		                        			
		                        			Epstein-Barr virus (EBV), a double-stranded DNA virus with an envelope, is a ubiquitous pathogen that is prevalent in humans, although most people who contract it do not develop symptoms (Kerr, 2019). While the primary cells EBV attacks are epithelial cells and B lymphocytes, its target range expands to a variety of cell types in immunodeficient hosts. Serological change occurs in 90% of infected patients. Therefore, immunoglobulin M (IgM) and IgG, serologically reactive to viral capsid antigens, are reliable biomarkers for the detection of acute and chronic EBV infections (Cohen, 2000). Symptoms of EBV infection vary according to age and immune status. Young patients with primary infection may present with infectious mononucleosis; there is a typical triad of symptoms including fever, angina, and lymphadenectasis (Houen and Trier, 2021). In immunocompromised patients, response after EBV infection may be atypical, with unexplained fever. The nucleic acid of EBV can be detected to confirm whether high-risk patients are infected (Smets et al., 2000). EBV is also associated with the occurrence of certain tumors (such as lymphoma and nasopharyngeal carcinoma) because it transforms host cells (Shannon-Lowe et al., 2017; Tsao et al., 2017).
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Trachea
		                        			;
		                        		
		                        			Epstein-Barr Virus Infections
		                        			;
		                        		
		                        			Herpesvirus 4, Human
		                        			;
		                        		
		                        			Virus Diseases
		                        			;
		                        		
		                        			Fever
		                        			;
		                        		
		                        			Granuloma
		                        			
		                        		
		                        	
9.Research progress of human bocavirus infection in children.
Chinese Critical Care Medicine 2023;35(5):548-553
		                        		
		                        			
		                        			Human bocavirus is a novel pathogen first detected in respiratory tract samples in 2005. People of different ages can be infected by human bocavirus. Children are the susceptible population, especially the infants aged from 6-24 months old. The epidemic season varies in different regions due to the differences in climate and geographical location, and it mainly occurs in autumn and winter. It's demonstrated that human bocavirus-1 is closely related to respiratory system diseases and even causes life-threatening critical illness. Also, the severity of symptom is positively correlated with viral load. Co-infections between human bocavirus-1 and other viruses often present high frequency occurrence. Human bocavirus-1 interferes immune function of host by inhibiting interferon secrete pathway. Currently, it remains limited knowledge and understanding of the roles of human bocavirus 2-4 in diseases, but the gastrointestinal diseases should be paid more attention. Detection of human bocavirus DNA by traditional polymerase chain reaction (PCR) assay shouldn't be regarded as conclusive diagnostic basis. Instead, combined with mRNA and specific antigen detection, it is beneficial to improve the accuracy of diagnosis. Till now, the knowledge of human bocavirus remains poorly studied, which is deserved to further progress.
		                        		
		                        		
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Human bocavirus
		                        			;
		                        		
		                        			Climate
		                        			;
		                        		
		                        			Coinfection
		                        			;
		                        		
		                        			Epidemics
		                        			;
		                        		
		                        			Interferons
		                        			
		                        		
		                        	
10.The Chinese herbal prescription JieZe-1 inhibits caspase-1-dependent pyroptosis induced by herpes simplex virus-2 infection in vitro.
Tong LIU ; Qing-Qing SHAO ; Wen-Jia WANG ; Tian-Li LIU ; Xi-Ming JIN ; Li-Jun XU ; Guang-Ying HUANG ; Zhuo CHEN
Journal of Integrative Medicine 2023;21(3):277-288
		                        		
		                        			OBJECTIVE:
		                        			JieZe-1 (JZ-1), a Chinese herbal prescription, has an obvious effect on genital herpes, which is mainly caused by herpes simplex virus type 2 (HSV-2). Our study aimed to address whether HSV-2 induces pyroptosis of VK2/E6E7 cells and to investigate the anti-HSV-2 activity of JZ-1 and the effect of JZ-1 on caspase-1-dependent pyroptosis.
		                        		
		                        			METHODS:
		                        			HSV-2-infected VK2/E6E7 cells and culture supernate were harvested at different time points after the infection. Cells were co-treated with HSV-2 and penciclovir (0.078125 mg/mL) or caspase-1 inhibitor VX-765 (24 h pretreatment with 100 μmol/L) or JZ-1 (0.078125-50 mg/mL). Cell counting kit-8 assay and viral load analysis were used to evaluate the antiviral activity of JZ-1. Inflammasome activation and pyroptosis of VK2/E6E7 cells were analyzed using microscopy, Hoechst 33342/propidium iodide staining, lactate dehydrogenase release assay, gene and protein expression, co-immunoprecipitation, immunofluorescence, and enzyme-linked immunosorbent assay.
		                        		
		                        			RESULTS:
		                        			HSV-2 induced pyroptosis of VK2/E6E7 cells, with the most significant increase observed 24 h after the infection. JZ-1 effectively inhibited HSV-2 (the 50% inhibitory concentration = 1.709 mg/mL), with the 6.25 mg/mL dose showing the highest efficacy (95.76%). JZ-1 (6.25 mg/mL) suppressed pyroptosis of VK2/E6E7 cells. It downregulated the inflammasome activation and pyroptosis via inhibiting the expression of nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (P < 0.001) and interferon-γ-inducible protein 16 (P < 0.001), and their interactions with apoptosis-associated speck-like protein containing a caspase recruitment domain, and reducing cleaved caspase-1 p20 (P < 0.01), gasdermin D-N (P < 0.01), interleukin (IL)-1β (P < 0.001), and IL-18 levels (P < 0.001).
		                        		
		                        			CONCLUSION
		                        			JZ-1 exerts an excellent anti-HSV-2 effect in VK2/E6E7 cells, and it inhibits caspase-1-dependent pyroptosis induced by HSV-2 infection. These data enrich our understanding of the pathologic basis of HSV-2 infection and provide experimental evidence for the anti-HSV-2 activity of JZ-1. Please cite this article as: Liu T, Shao QQ, Wang WJ, Liu TL, Jin XM, Xu LJ, Huang GY, Chen Z. The Chinese herbal prescription JieZe-1 inhibits caspase-1-dependent pyroptosis induced by herpes simplex virus-2 infection in vitro. J Integr Med. 2023; 21(3): 277-288.
		                        		
		                        		
		                        		
		                        			Caspase 1/metabolism*
		                        			;
		                        		
		                        			Inflammasomes/pharmacology*
		                        			;
		                        		
		                        			NLR Family, Pyrin Domain-Containing 3 Protein/metabolism*
		                        			;
		                        		
		                        			Pyroptosis
		                        			;
		                        		
		                        			Simplexvirus/metabolism*
		                        			;
		                        		
		                        			Drugs, Chinese Herbal/pharmacology*
		                        			;
		                        		
		                        			Herpes Simplex/drug therapy*
		                        			;
		                        		
		                        			Humans
		                        			
		                        		
		                        	
            
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